Alopecia Areata: Dermatoscopic (Trichoscopic) Features

Dermatoscopic (Trichoscopic) Features

Up close examination of the scalp via dermoscopy allows the physician the opportunity to confirm the suspected type of hair loss and also evaluate how active the condition is at the present time. There are many known “dermatoscopic” features of alopecia areata and I will review five common ones here:

Yellow dots (red arrow) represent empty hair follicle openings (pores) and are very common. The more severe of a disease a patient has, the more yellow dots are seen all over the scalp.

Vellus hairs (white arrow) are short and thin regrowing hairs and are also common in patients with alopecia areata.

Black dots (black arrow) represent hair follicles broken at the surface and indicate an active disease state.

Tapered hairs (blue arrow) are long hairs that become quite thin as the are about to enter the scalp. They too represent active disease.

Exclamation mark hairs (green arrow) are short 4 mm hairs that are actually broken hairs. They are wider at the top compared to the bottom and are found in patients with active disease.